NPIMap

Organization Active NPI

Shin Imaging LLC

Doing business as Shin Imaging Center

  • Radiology Clinic/Center
  • Buena Park, CA
National Provider Identifier
1538660410
Registry record updated Feb 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
SHIN IMAGING LLC
Doing business as
Shin Imaging Center
Practice address
5832 Beach Blvd Ste 104
Buena Park, CA 90621-2022
Phone
(714) 578-8882
Fax
(714) 578-8886
NPI assigned
Feb 26, 2018
Last updated
Feb 26, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Charles Maloney
Title
President
Phone
(714) 578-8882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

5832 Beach Blvd Ste 104
Buena Park, CA 90621-2022

Mailing address

1955 Sunny Crest Dr Ste 110
Fullerton, CA 92835-3653
Phone (714) 578-8882

Other names 1

  • Shin Imaging Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180605000385 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 1850677402 Practice locations: Buena Park, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Shin Imaging2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

18310 US Highway 18
Apple Valley, CA 92307
Phone (760) 961-5555

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1519603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519603200000",
    "number": "1538660410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 SUNNY CREST DR STE 110",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353653",
            "telephone_number": "714-578-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5832 BEACH BLVD STE 104",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906212022",
            "telephone_number": "714-578-8882",
            "fax_number": "714-578-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIN IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-26",
        "last_updated": "2018-02-26",
        "status": "A",
        "authorized_official_last_name": "MALONEY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-578-8882"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shin Imaging Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Buena Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.